When a person is involved in an accident or is injured in any way and it is considered possible that the person may have sustained a spinal injury it is essential that the person be immobilized in such a way that minimal stress is placed upon the spine, such stress, typically caused by movement, possibly resulting in fatal or crippling injury. For this reason, emergency response personnel, typically ambulance crew and paramedics, carry spinal restraints in their vehicles for use in immobilizing and safely transporting a person with a suspected spinal injury.
The traditional spinal restraint is known as a fracture or spine board and is simply a planar plywood sheet provided with hand holds spaced along the side of the board. The board is typically slid beneath the patient, who is already fitted with a cervical collar, and then lateral straps are used to firmly secure the patient to the board. This form of board has the advantages of low cost and simplicity. The planar board is also very compact, which is essential due to the limited space available on ambulances and the like, and thus allows up to four boards to be carried by a single ambulance: though local regulations may vary, it is common for local health authorities to require that an ambulance carries at least two boards.
The use of this form of board requires the provision of separate restraint straps which must be separately stored and carried and which may well be mislaid and it can be difficult to secure a patient using only lateral restraint straps. Also, the provision of hand holds only on the side of the board may also present problems when a patient has to be carried through a narrow opening.
Certain spine boards are also provided with fixed foot rests, such as the Imperial Back Board with Foot Rest (Trade-mark), as supplied by Safety Supply Canada, of Richmond Hill, Ontario. A further board is disclosed in U.S. Pat. No. 4,369,982 to Hein et al, which discloses a spine board having a detachable foot support to prevent a patient from sliding off the board when it is raised from the horizontal position. The foot support assembly may be positioned in one of various positions by providing pin receiving apertures at the foot of the board for engagement with pins provided on the foot support. The patent also discloses the use of a wheel assembly which may be fixed to the spine board so that the board can be easily transported by one person.
A further variation on the basic board is disclosed in U.S. Pat. No. 4,655,206 to Moody, which describes a spinal restraint comprising a rigid board and a strap for tying the patient to the board. Various slots are provided in the edge of the board such that the strap can be laced from side to side over the patient. The restraint also includes a U-shaped head restraint pad which may be slid onto the head of the patient after the patient has been placed on the board, and which is secured to the board by clips and also by the strap which extends over shoulder engaging portions of the head restraint.
In U.S. Pat. No. 4,267,830 to Vick there is disclosed a combination spine board and head stabilizer, the head stabilizer being removably mounted on the board and being provided with head brackets swivally mounted on a head bracket support, the height and spacing of the head brackets being adjustable to suit patients of different sizes. A chin strap is also provided. Restraining straps are provided and are provided with a locking mechanism for locking the ends of the strap to the board, the strap ends including a releasable latch device for location in apertures provided at various positions on the board.
A somewhat different form of restraint is also available, in the form of a vest and head restraint which can be used to immobilize the upper body of a patient, the vest being attached to the body of the patient while the head restraint is used to immobilize the head. Such a device, known as the Tacit Cervical Immobilization Device (Trade-mark) is available from Safety Supply Canada of Richmond Hill, Ontario. A somewhat simpler restraint device with a less sophisticated head restraint is available as the LSP Miller Full Body Splint/Litter, also available from Safety Supply Canada.
Although a number of the restraints described above are adaptable to receive patients of different sizes, the adaptation is generally not a particularly simple operation; for example, in the Hein et al Spine Board, to move the foot support assembly requires the foot support to be removed from the board and repositioned in a new position, and in the Vick Combination Spine Board and Head Stabilizer, the adjustable straps must be removed from the apertures in the board and placed in the appropriately located apertures.
Also, it is preferable to provide some traction for the patient to minimize compression stress on the possibly damaged spine. The only device in which this is addressed is the Tacit Cervical Immobilization Device in which the head restraint is moveable relative to the body vest. However, it would appear that adjustment of the device would be quite difficult.